Individual
ABIGAEL KUZMANICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1845 GRANDSTAND PL, ELGIN, IL 60123-6603
(847) 695-0484
Mailing address
107 FORSYTHE LN, DEKALB, IL 60115-2337
(815) 501-0441
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PPP001231523
BLUE CROSS BLUE SHIELD
IL
Enumeration date
05/15/2019
Last updated
05/15/2019
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